The focus of our visit was to follow up the improvements required on care and welfare of people who use services identified as needed from our inspection in August 2012.

At this visit, we found that improvements in the service had been made, so that people who use the service received safe and effective care.

We met and spoke with two people during our visit and they told us that the found the care to be “good and supportive.” One person told us, “staff are always come to talk with you and you feel helped.” We visited Oakdene, Maples (Psychiatric Intensive Care Unit) and Hawthorns wards. On the day of our inspection there were 14 patients on Oakdene ward, 12 patients on Hawthorns ward and five patients on Maples ward

Following concerns raised about the service, we carried out an inspection to look at the care and treatment provided patients who used the service. We visited Oakdene, Maples (Psychiatric Intensive Care Unit) and Hawthorns wards. On the day of our inspection there were 15 patients on Oakdene ward, 14 patients on Hawthorns ward and six patients on Maples ward

We spoke with ten patients and they told us how they were informed, involved and supported to make choices about their care and treatment. Most (eight) patients described their overall experience as positive. For example, they told us they had access to outdoor space and had opportunities to engage with advocacy and professionals regarding their care and treatment. Most patients (eight) we spoke with told us they felt able to express their views and that their privacy and dignity were respected. Two patients told us the care was acceptable.

Seven patients we spoke with were complimentary about the staff. Four patients told us that members of staff were thoughtful. They said they did not get bored and they were happy with the range of activities available. They also said they felt safe. They were aware of the plans for their future and spoke positively about the progress they had made at the hospital. One patient told us that they were sometimes bored and wanted to access more activities. They told us that the occupational therapist assistant arranged for them to have access to other outdoor activities that they enjoyed. Two patients did not share any views about their hospital experience.

We visited the following wards at St James Hospital: Fairoak, Maples, Hawthorns and Oakdene. These are mental health inpatient wards We spoke to people who use services and they told us that members of staff were “kind and thoughtful.” A number of them told us that “there is always someone to talk to.” People told us there were a range of activities on the ward and they could choose to join in the programmes. We spoke to three people and they told us that the occupational therapists supporting the wards gave them “lots of support.” One person told us there is “lots of tender, loving care here.”

People told us that they were happy with the arrangements for cleaning of patient nail care instrument.

St James' Hospital is the registered location from where Solent NHS Trust provides all its mental health services. The Trust provides mental health services including Child and Adolescent Mental Health Services (CAMHS) for the 220,000 people residing in the City of Portsmouth and some CAMHS services in Southampton.

Overall we found that people received a safe and caring service. People reported feeling well cared for and receiving a compassionate service. People's physical health needs were well managed. We saw positive examples of collaborative working and active engagement with local black minority and ethnic (BME) groups through the community development workers employed by the trust in partnership with Portsmouth City Council. The evidence seen showed us that this had led to an increase in service engagement of these specific groups and demonstrated a pro-active approach to community engagement by the trust.

We found that improvements need to be made in respect of safety at the Kite Unit where there were a lack of specific male and female areas and some fixtures and fittings could present increased risks. In adult community services staffing levels may present risks to safety for people using the services. We also found that staffing levels within the adult community teams were low and improvements were needed to ensure access and safety was maintained.